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Published in: European Journal of Orthopaedic Surgery & Traumatology 2/2019

01-02-2019 | General Review • UPPER LIMB - NERVE GRAFT

Traumatic upper plexus palsy: Is the exploration of brachial plexus necessary?

Authors: Ioannis Gkiatas, Dimitrios Papadopoulos, Anastasios Korompilias, Marios Vekris, Alexandros Beris, Ioannis Kostas-Agnantis

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2019

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Abstract

Brachial plexus injuries are major injuries of the upper limb resulting in severe dysfunction usually in young patients. Upper trunk injuries of the brachial plexus account for approximately 45% of brachial plexus injuries. Treatment options for upper trunk brachial plexus injuries include exploration of the plexus and microsurgical repair using nerve grafts or nerve transfers. Several published studies presented the results of both techniques, but there are few studies which compared these two techniques. This article summarizes the treatment options for upper trunk brachial plexus injuries, discusses the merits and demerits of each technique, and presents authors’ proposed treatment for these injuries.
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Metadata
Title
Traumatic upper plexus palsy: Is the exploration of brachial plexus necessary?
Authors
Ioannis Gkiatas
Dimitrios Papadopoulos
Anastasios Korompilias
Marios Vekris
Alexandros Beris
Ioannis Kostas-Agnantis
Publication date
01-02-2019
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-018-2345-1

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